Bone structural and mechanical indices in Adolescent Idiopathic Scoliosis evaluated by high-resolution peripheral quantitative computed tomography (HR-pQCT)

Wing Sze Yu; Ka Yan Chan; Fiona Wai Ping Yu; Bobby Kin Wah Ng; Kwong Man Lee; Ling Qin; Tsz Ping Lam; Jack Chun Yiu Cheng

doi:10.1016/j.bone.2013.12.033

Bone structural and mechanical indices in Adolescent Idiopathic Scoliosis evaluated by high-resolution peripheral quantitative computed tomography (HR-pQCT)

Bone. 2014 Apr:61:109-15. doi: 10.1016/j.bone.2013.12.033. Epub 2014 Jan 8.

Authors

Wing Sze Yu¹, Ka Yan Chan¹, Fiona Wai Ping Yu¹, Bobby Kin Wah Ng¹, Kwong Man Lee², Ling Qin³, Tsz Ping Lam¹, Jack Chun Yiu Cheng⁴

Affiliations

¹ Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong, China; Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Hong Kong and Nanjing, China.
² Lee Hysan Clinical Research Laboratories, The Chinese University of Hong Kong, Shatin, Hong Kong, China; Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Hong Kong and Nanjing, China.
³ Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong, China; Bone Quality and Health Assessment Centre, Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong, China.
⁴ Department of Orthopaedics and Traumatology, The Chinese University of Hong Kong, Shatin, Hong Kong, China; Joint Scoliosis Research Center of the Chinese University of Hong Kong and Nanjing University, Hong Kong and Nanjing, China. Electronic address: jackcheng@cuhk.edu.hk.

PMID: 24412702
DOI: 10.1016/j.bone.2013.12.033

Abstract

Adolescent Idiopathic Scoliosis (AIS) is associated with systemic low bone mass. It could persist into adulthood and was shown to be an important prognostic factor for curve progression in AIS. Previous studies were confined to areal bone mineral density (aBMD) measured by Dual-energy X-ray Absorptiometry (DXA) which was a two-dimensional measurement for a three-dimensional structure. This conventional measurement was inadequate to evaluate volumetric bone density and bone quality which are important determinants for bone strength and bone health status as defined in the 2000 NIH consensus statement. High-resolution peripheral quantitative computed tomography (HR-pQCT) was therefore used in this study for three-dimensional evaluation of volumetric bone mineral density and bone micro-architecture as well as estimation of bone strength. In this study, 214 newly diagnosed AIS girls and 187 age and gender-matched normal control aged between 11 and 13years old were recruited for HR-pQCT evaluations on bone geometry, trabecular bone micro-architecture and volumetric BMD (vBMD) at the non-dominant distal radius. We demonstrated that AIS was associated with lower Cortical Bone Area, Cortical Bone vBMD, Trabecular Number and greater Trabecular Separation. With multivariate linear regression analysis and after adjustment for age, dietary calcium intake and physical activity level, the association of AIS with lower Cortical Bone vBMD, lower Trabecular Number and greater Trabecular Separation remained statistically significant. The findings of this study indicated that AIS was associated with an abnormal bone quality profile suggestive of alteration in endocortical modeling, derangement in trabecular bone structure and disturbance in bone mineralization. The cause for these changes and how they are related to the etiopathogenesis of AIS warrant further studies.

Keywords: Adolescent Idiopathic Scoliosis; Bone quality; Cortical bone; HR-pQCT; Low bone mass; Trabecular bone.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adolescent
Bone Density
Bone and Bones / radiation effects*
Child
Female
Humans
Scoliosis / diagnostic imaging*
Tomography, X-Ray Computed / methods*